| NPI | 1134514201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine, Rheumatology (Licence: MN 66705) |
| Additional Taxonomies | 207RR0500X Internal Medicine, Rheumatology (Licence: WI 72681-20) |
| Enumeration Date | 2015-04-05 |
| Last Update Date | 2026-06-26 |